Organization Name: | HEALTHREACH COMMUNITY HEALTH CENTERS |
NPI Number: | 1316910193 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CONSTANCE R COGGINS (PRESIDENT/CEO) |
Mailing Address: | 10 Water St Ste 305 Waterville |
State: | ME US |
Postal Code: | 049016559 |
Phone Number: | 2078725610 |
Fax Number: | 2076609901 |
NPI Enumeration Date: | 02/10/2006 |
NPI Last Update Date: | 11/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | E58728 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |